National Dialogue: Solution to Ending Health Workers Strikes in Kenya

Author: Gilbert Wangalwa, Amref Health Africa

The health sector in any country is the greatest pillar of wealth generation in a country. The life of citizens and by extension the economy depends largely on an effective and efficient health system. Low and middle-income countries like Kenya in which the health workforce goes on strike almost every year, should not expect to make any gains in the fight to reduce poverty. There is already a noticeable upsurge of poverty in the country, dealing a blow to the country’s goal of becoming a developed economy by 2030.

The dilemma of the right of employees to strike and the citizen’s right to health are two delicate and conflicting constitutional provisions that continue to elude policy and the legislative environment. A balance between ethical considerations by health professionals and management prudence to prevent the recurrence of strikes requires a national debate. The negative effect of strikes not only hampers economic growth but is also great harm to patients and the broader public.

Kenya has experienced many and longer health workers’ strikes in its history during the post-devolution era. The inability of the government to prevent strikes from occurring or escalating is a demonstration of its limited capacity to manage and negotiate industrial disputes. The unionized health workers have lost trust and confidence in the government to settle their demands. The government has on several occasions not honored the collective bargaining agreements. There has been no conclusive action on run-away corruption in the health sector. A select few elite government employees continue to live in opulence. These factors make it difficult for health workers to believe that the government is financially constrained to offer a reasonable compensation package and an enabling workplace environment.

It’s opportune time for the government to accept its failure to resolve strikes and institute an open debate on managing strikes in the country. More so insulating innocent third parties from the impact of strikes. Many innocent and sick citizens with no stake in the dispute are denied medical services leading to excruciating pain or death. Families are deprived of key assets to access costly medical services in private health facilities and the associated psychological trauma.

It’s only through national dialogue that the national and county governments can appreciate the complexity of the health system in order to proactively think around possible effects of interventions, policies and legislation. The debate will define and clarify the role of each government structure to prevent or respond to strikes and prevent disruption of essential services like health. It will be a good opportunity to come up with mechanisms to ensure that the poorest households and communities are protected from health-related and financial losses.

The discussions will help rebuild relationships between the two levels of government and the healthcare workers’ unions. There should be careful consideration of the compensation packages of health workers across the different cadres including creation of a conducive working environment to offer quality services.

There are still many unanswered questions: What is the amount of medicines in public medical stores and pharmacies/KEMSA that have gone to waste due to expiry? What is preventing the anti-corruption agencies from resolving the runaway corruption in the health sector? What has stopped government from dialoging with union officials?